Exaggerated blood pressure responses during mental stress are prospectively related to enhanced carotid atherosclerosis in middle-aged Finnish men

J. Richard Jennings, Thomas W. Kamarck, Susan A. Everson-Rose, George A. Kaplan, Stephen B. Manuck, J. T. Salonen

Research output: Contribution to journalArticle

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Abstract

Background - Hemodynamic reactions to mental stress may contribute to atherosclerosis. We previously observed cross-sectional relationships between blood pressure reactions to a standardized stress battery and carotid intima-media thickness (IMT) in the Kuopio Ischemic Heart Disease (KIHD) study. These are the first prospective results on this relationship. Methods and Results - Men from 4 age cohorts (42 to 60 years old at study onset) were challenged with a standardized mental stress battery, and heart rate and blood pressure reactions were assessed. Ultrasound measures of common carotid IMT were collected at this time and 7 years later as noninvasive markers of atherosclerosis. Data were collected from a sample of 756 men at both times. Systolic blood pressure reactions to mental stress at study onset were positively related to mean carotid IMT 7 years later (β=0.035, P=0.001, by blood pressure quartile, IMT=0.91, 0.93, 0.96, 1.00 mm) and to the progression of IMT (β=0.020, P=0.006, by blood pressure quartile, ΔIMT=0.08, 0.09, 0.11, 0.11 mm). Similar significant relations were shown for maximal IMT and plaque height. Diastolic blood pressure responses were less strongly related to carotid IMT than were systolic responses. Heart-rate responses were unrelated. Adjustment for standard risk factors did not substantially reduce the relation between systolic blood pressure reactivity and the progression of mean carotid IMT (standardized β=0.059, P=0.026), maximal carotid IMT (standardized β=0.084, P=0.006), or plaque height (standardized β=0.093, P=0.008). Conclusions - The degree of systolic blood pressure reactivity to mental challenge is prospectively related to carotid IMT in middle-aged and older men, independent of known risk factors.

Original languageEnglish (US)
Pages (from-to)2198-2203
Number of pages6
JournalCirculation
Volume110
Issue number15
DOIs
StatePublished - Oct 12 2004

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Carotid Artery Diseases
Carotid Intima-Media Thickness
Blood Pressure
Atherosclerosis
Heart Rate
Myocardial Ischemia
Hemodynamics

Keywords

  • Atherosclerosis
  • Cardiovascular diseases
  • Carotid arteries
  • Risk factors
  • Stress

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Exaggerated blood pressure responses during mental stress are prospectively related to enhanced carotid atherosclerosis in middle-aged Finnish men. / Jennings, J. Richard; Kamarck, Thomas W.; Everson-Rose, Susan A.; Kaplan, George A.; Manuck, Stephen B.; Salonen, J. T.

In: Circulation, Vol. 110, No. 15, 12.10.2004, p. 2198-2203.

Research output: Contribution to journalArticle

Jennings, J. Richard ; Kamarck, Thomas W. ; Everson-Rose, Susan A. ; Kaplan, George A. ; Manuck, Stephen B. ; Salonen, J. T. / Exaggerated blood pressure responses during mental stress are prospectively related to enhanced carotid atherosclerosis in middle-aged Finnish men. In: Circulation. 2004 ; Vol. 110, No. 15. pp. 2198-2203.
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T1 - Exaggerated blood pressure responses during mental stress are prospectively related to enhanced carotid atherosclerosis in middle-aged Finnish men

AU - Jennings, J. Richard

AU - Kamarck, Thomas W.

AU - Everson-Rose, Susan A.

AU - Kaplan, George A.

AU - Manuck, Stephen B.

AU - Salonen, J. T.

PY - 2004/10/12

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N2 - Background - Hemodynamic reactions to mental stress may contribute to atherosclerosis. We previously observed cross-sectional relationships between blood pressure reactions to a standardized stress battery and carotid intima-media thickness (IMT) in the Kuopio Ischemic Heart Disease (KIHD) study. These are the first prospective results on this relationship. Methods and Results - Men from 4 age cohorts (42 to 60 years old at study onset) were challenged with a standardized mental stress battery, and heart rate and blood pressure reactions were assessed. Ultrasound measures of common carotid IMT were collected at this time and 7 years later as noninvasive markers of atherosclerosis. Data were collected from a sample of 756 men at both times. Systolic blood pressure reactions to mental stress at study onset were positively related to mean carotid IMT 7 years later (β=0.035, P=0.001, by blood pressure quartile, IMT=0.91, 0.93, 0.96, 1.00 mm) and to the progression of IMT (β=0.020, P=0.006, by blood pressure quartile, ΔIMT=0.08, 0.09, 0.11, 0.11 mm). Similar significant relations were shown for maximal IMT and plaque height. Diastolic blood pressure responses were less strongly related to carotid IMT than were systolic responses. Heart-rate responses were unrelated. Adjustment for standard risk factors did not substantially reduce the relation between systolic blood pressure reactivity and the progression of mean carotid IMT (standardized β=0.059, P=0.026), maximal carotid IMT (standardized β=0.084, P=0.006), or plaque height (standardized β=0.093, P=0.008). Conclusions - The degree of systolic blood pressure reactivity to mental challenge is prospectively related to carotid IMT in middle-aged and older men, independent of known risk factors.

AB - Background - Hemodynamic reactions to mental stress may contribute to atherosclerosis. We previously observed cross-sectional relationships between blood pressure reactions to a standardized stress battery and carotid intima-media thickness (IMT) in the Kuopio Ischemic Heart Disease (KIHD) study. These are the first prospective results on this relationship. Methods and Results - Men from 4 age cohorts (42 to 60 years old at study onset) were challenged with a standardized mental stress battery, and heart rate and blood pressure reactions were assessed. Ultrasound measures of common carotid IMT were collected at this time and 7 years later as noninvasive markers of atherosclerosis. Data were collected from a sample of 756 men at both times. Systolic blood pressure reactions to mental stress at study onset were positively related to mean carotid IMT 7 years later (β=0.035, P=0.001, by blood pressure quartile, IMT=0.91, 0.93, 0.96, 1.00 mm) and to the progression of IMT (β=0.020, P=0.006, by blood pressure quartile, ΔIMT=0.08, 0.09, 0.11, 0.11 mm). Similar significant relations were shown for maximal IMT and plaque height. Diastolic blood pressure responses were less strongly related to carotid IMT than were systolic responses. Heart-rate responses were unrelated. Adjustment for standard risk factors did not substantially reduce the relation between systolic blood pressure reactivity and the progression of mean carotid IMT (standardized β=0.059, P=0.026), maximal carotid IMT (standardized β=0.084, P=0.006), or plaque height (standardized β=0.093, P=0.008). Conclusions - The degree of systolic blood pressure reactivity to mental challenge is prospectively related to carotid IMT in middle-aged and older men, independent of known risk factors.

KW - Atherosclerosis

KW - Cardiovascular diseases

KW - Carotid arteries

KW - Risk factors

KW - Stress

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